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VA Form 21P-534EZ

Form name: Application for DIC, Survivors Pension, and/or Accrued Benefits
Form revision date: August 2025
Related to: Disability, Family member benefits, Pension

When to use this form

Use this application if you’re the surviving spouse or child of a Veteran and want to apply for survivors benefits. You can also submit evidence with your application to get a faster decision.

Downloadable PDF

DIC eligibility for survivors of Blue Water Navy Vietnam Veterans

If we denied your Blue Water Navy Veteran’s service-connected disability claim in the past, you may be eligible for DIC benefits based on the Blue Water Navy Vietnam Veterans Act of 2019.

Learn more about DIC eligibility information

Find out how to apply for benefits

Veterans who served on a Blue Water Navy vessel offshore of the Republic of Vietnam, or on another U.S. Navy or Coast Guard ship operating in the coastal waterways of Vietnam between November 1, 1955, and May 7, 1975, are now entitled to a presumption of service connection for illnesses related to Agent Orange exposure. This is a result of Public Law 116-23, also known as the Blue Water Navy Vietnam Veterans Act of 2019.

Learn  more about service connection for illnesses related to Agent Orange exposure

Online tool

You can apply online instead of filling out and sending us the paper form.

  • VA Form 21P-0969

    Form name: Income and Asset Statement for Pension or Parents’ Dependency and Indemnity Compensation (DIC) Claims

    Use VA Form 21P-0969 when you’re instructed to while completing VA Forms 21P-527EZ or 21P-534EZ.

    You can also submit it when you need to verify or update your income or net worth. If you need to report changes over multiple years, submit a separate VA Form 21P-0969 each year.

  • VA Form 21-2680

    Form name: Examination for Housebound Status or Permanent Need for Regular Aid and Attendance

    Use VA Form 21-2680 to apply for Aid and Attendance benefits that will be added to your monthly compensation or pension benefits.

  • VA Form 21P-8416

    Form name: Medical Expense Report

    Use VA Form 21P-8416 to report medical or dental expenses that you have paid for yourself or for a family member living in your household. These must be expenses you weren’t reimbursed for and don’t expect to be reimbursed for.

Helpful links related to VA Form 21P-534EZ

  • As the surviving spouse, child, or parent of a service member who died in the line of duty, or the survivor of a Veteran who died from a service-related injury or illness, you may be eligible for VA DIC payments.

  • The Fully Developed Claim (FDC) program is the fastest way to get your VA pension claim processed. Learn more about the FDC program.

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